How does health cover work for entrepreneurs in France

Registering a business in France will entitle you to a health coverage, provided it is your main activity. A French social security number will be created for you and you will be issued a health card - carte vitale . It all seems easy; however, setting up your French health cover can be a long and stressful process.

Health cover and auto entrepreneurs

Registering an auto-entrepreneur (also called micro entrepreneur) will generate a heath cover and you will not be using the S1 anymore. You will also get a permanent social security number created with your business. However, If your business income is lower than €3,862 per year, then you may have to pay into the health system with PUMA. Your business income will be assessed by taking 29% of your turnover for sales and gites activities, 50% for artisan services and 66% for professions liberales.

Getting a Carte Vitale in France for business owners

When registering your business in France, be it an auto-entrepreneur, entreprise individuelle or an incorporated business such EURL, SARL or SAS, you will choose the body that will handle your healthcare. This body, called organisme santé could be for instance RAM, Harmonie Mutuelle, Mutuelle du Soleil, etc.

All bodies health bodies will provide the same level of healthcare and are validated by the government. Make sure you write down the name of that body when registering your business, so you know who to chase!

As part of the business registration process, a French social security number called numéro de sécurité sociale will be created for you. If you are new to France, this can take a while, as you will have to provide a proof of your identity (birth certificate, mariage certificate, passport), and sometimes have it translated by an official translator.

You might have to supply these documents several times, as they are not always automatically passed from one body to the other... Don't lose patience, but be sure you provide the right document requested (sometimes even twice), or this will block your health coverage set up.

Once your social security number is created, your healthcare body will issue a temporary certificate -attestation de couverture santé to confirm that you are covered. Finally, after supplying a picture and completing one last form, you will receive your carte vitale.

Take time to set up and chase your French health coverage

You have finally received your carte vitale! Great news, but there is still a bit of work for you to do. Don't assume your health cover is fully set up with all your family members. Here's what you need to do, as soon as you get a letter from your organisme santé:

Create your online account with your organisme santé.

Check that your family members are listed on your health coverage. If not, this needs chasing.

Download your health certificate - attestation de couverture santé. You will need this for doctors’ appointments, until you get your carte vitale.

Add your bank details to be reimbursed for your health expenses (doctors’ fees and medicine are paid upfront in France).

Declare your family doctor by downloading and completing the déclaration de médecin traitant form. Doctors are reimbursed slightly less if you don't have a main doctor (- 1€ per consultation).

You've done all that? Congratulations! You have done your share of admin work for the next 6 months! Everything will be easy from now on.

Update on entrepreneurs' healthcover in February 2019

From January 2019, the healthcover for all new entrepreneurs will be managed by CPAM (Sécurité Sociale). Existing entrepreneurs, having created their businesses before 2019, will slowly be moved to CPAM too, but it will take up to two years. It is hoped that the healthcover being managed by CPAM, will enable people to switch from one regime to the other in a smoother and more efficient manner.

I've been helping people who want to start or already have a small business set up in France since 2009. After graduating from a Master of Business Administration (MBA) degree, I worked as a senior marketing consultant in the UK and France for various International companies. I worked as a conseillère en création d'entreprises (senior business advisor) for BGE here in France and run this independent business on a daily basis.